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The Educational Environment Is Warming Up: Response to Changes in a Component of a Medical Curriculum



The Dundee Ready Educational Environment Measure (DREEM) is a valid instrument to evaluate the educational environment of institutions. This quantitative study aimed to discover if applying interactive educational approaches to a component of a traditionally taught medical curriculum improved the educational environment, as measured by the DREEM.


The bilingual Arabic-English DREEM questionnaire was distributed twice to all third-year medical students (273 students) at the Hashemite University in Jordan. The first data collection occurred at the completion of a traditionally taught component of the Neurology module and the second data collection at the end of an interactively taught component of the same module. A paired t-test was used to compare the results.


The total DREEM score for the innovative interactive course was 120.04/200 (from 183 questionnaires) and for the traditionally taught course was 114.69/200 (from 198 questionnaires). Of the five DREEM sub-scales, the interactive course scored statistically significantly higher than the traditionally taught course for “perceptions of learning” and “perceptions of atmosphere” (p-value 0.013 and 0.011, respectively). The interactively taught course was particularly valued by students for being participative, student-centered, and developing their professional competence. The lowest scoring item for both courses was “there is a good support system for students who get stressed.”


This study demonstrated that students value interactive learning environments and that there is benefit in introducing these components to a traditionally taught medical curriculum, when it may not be feasible to bring innovation to the entire medical curriculum due to resource constraints.

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Fig. 1

Availability of Data and Material

The datasets generated and analyzed during the current study are available in the Mendeley Data Repository.


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The authors wish to acknowledge Professor Ibrahim AlAyed, College of Medicine, King Saud University, Saudi Arabia, for providing the Arabic-English DREEM questionnaire.

Author information




Together KM and AA conceived and designed the study. AA was the major contributor in gathering the data. MY was the major contributor in analyzing and interpreting the data. KM was the major contributor in writing and editing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Katherine Miles.

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Ethics Approval and Consent to Participate

The study proposal was submitted to the Hashemite University Ethics Committee which concluded that the study could be conducted without formal approval since the study did not include interventions on human subjects and consent to participate was obtained by participants signing a consent form.

Conflicts of Interests

The authors declare no competing interests.

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Research was conducted at the Faculty of Medicine, The Hashemite University, Zarqa, Jordan.

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Miles, K., Al-Shudifat, AE. & Yousuf, M.S. The Educational Environment Is Warming Up: Response to Changes in a Component of a Medical Curriculum. Med.Sci.Educ. 31, 1677–1684 (2021).

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  • DREEM questionnaire
  • Medical education
  • Student perceptions
  • Educational environment